Research studies have shown that psycho-social intervention strategies

Attention deficit hyperactivity disorder (ADHD) is a problem that affects thousands of people throughout the United States. People who are suffering from ADHD experience a wide variety of symptoms including impulsivity, inability to pay attention to details, depression and other symptoms that may create problems in their interpersonal relationships.

Research studies have shown that psycho-social intervention strategies can be helpful in helping ADHD patients, if they are introduced to those with ADHD at a relatively young age. The main problem lies in the fact that ADHD is notoriously difficult to diagnose at an early age, and is often ignored in adults.

Therefore the problems with interpersonal relationships experienced by very young sufferers of ADHD and the adult with ADHD remain primarily ignored by the psychological community. When the majority of psycho-social treatment programs that treat interpersonal issues with the ADHD patient are focused on school aged children and adolescents how do we help the thousands of adults and young children with ADHD who are left out in the cold?

For the purposes of this paper ADHD can be operationally defined as a cognitive disorder which involves an impaired ability to focus on certain tasks that require attention to detail. ADHD also involves difficulties with impulse control, depression, self-regulation, and interpersonal relationships. Finally, ADHD may also involve learning disabilities or cognitive difficulties resulting from a child’s inability to pay attention for long periods of time.

While reading this paper some might also come to question what is meant by interpersonal relationships. Interpersonal relationships are easily defined in terms of this paper. Interpersonal relationships are any relationships in which the person suffering from ADHD participates.

These relationships can be parent/child relationships, romantic relationships, friendships, or relationships with employers and co-workers.

People with ADHD suffer a certain level of social dysfunction that may prevent these interpersonal relationships from being either as rewarding, or as fulfilling as they might be otherwise, therefore, methods must be developed in order to help people with ADHD deal with and cope with interpersonal relationships in a healthy way and to address ADHD issues positively within these relationships.

I. Literature Review

Nijmeier, Mindaraa, Buitelaar, Mulligan, Hartmaan, and Hoekstraa (2008) argue that one of the key problems for children with ADHD is that the common symptoms of ADHD such as, impulsivity can cause difficulties in their interpersonal relationships. Impulsive behaviors or aggression can be mistaken as deliberate bullying or other negative behaviors that teachers see as deliberate.

Nijmeier et al (2008) state that an estimated 3. 5% of all schoolchildren at the worldwide level suffer the symptoms of ADHD and more than half of these children will continue to experience ADHD symptoms throughout adolescence and adulthood. Nijmeier et al state that, one of the main areas in which interpersonal relationships may be impaired for people with ADHD, especially, children is that their hyperactive and impulsive behaviors may lead to the child suffering a certain amount of bullying, teasing, or rejection by their peers.

Finally, Nijmeier et al (2008) make it clear that not all children with ADHD experience impairments in their interpersonal relationships- some children merely experience difficulties with school and schoolwork while others experience problems both with school and interpersonal relationships.

Hoza et al. (2005) also discuss how a child’s relationships with peers can be impaired when a child has ADHD. They hypothesize that the impulsivity and hyperactivity that is typical to a child with ADHD make it very difficult for a child to maintain strong interpersonal relationships during their elementary school years.

This is primarily because ADHD symptoms may cause a child to behave in ways that other children may not understand, or that may be seen as acts of aggression against other children. Hoza et al (2005) studied 165 children with ADHD. The sample included 130 males and 35 females.

These children were rated for social behaviors and interpersonal relationships by classmates of the same sex. Hoza et al (2005) discovered that children with ADHD experienced several problems in terms of interpersonal relationships. First, children with ADHD typically did not have dyadic relationships.

This essentially meant that ADHD children did not have a “ best friend” a normal occurrence during the elementary school years. ADHD children were also perceived by their peers were often not well liked by their peers and tended to be ignored socially. Popular children tended to scorn them, and these children were often seen by others either as class clowns, or bullies.

This study evidenced several critical weaknesses one of which was the fact that there appeared to be little if any contribution in terms of social perceptions and interpersonal relationships from the adults in the child’s lives.

Teachers and administrators were not reviewed for their opinions and the small sample size of the study may also have created difficulties in terms of how generalizable the study was to all elementary aged children with ADHD. Overall, however, this study presented a powerful illustration of how the peers of children with ADHD think of them, and how these opinions influence the ability of ADHD children to maintain interpersonal relationships with others.

Adolescence creates new problems for people with ADHD. These problems include increasing problems with parents and increasing discord  within the family as ADHD symptoms can lead to substance abuse and criminal behavior as adolescents with ADHD self medicate to control symptoms, and have increasing troubles with impulsivity.

Wymbs, Pelham, Molina, and Gnagy (2008) report that adolescents with ADHD report that there is more conflict between their parents as a result of the adolescents ADHD, and that adolescents with ADHD are more likely to misinterpret  parental discord and overreact than are children without ADHD.

In a study of 46 children with comorbid ADHD and Oppositional Defiant Disorder (ODD) or Conduct Disorder (CD), 26 children with ADHD alone, and 88 children without ADHD or ODD, Wymbs et al (2008) report that children with CD and ADHD were more likely to report problems with familial interpersonal relationships both between their parents and between themselves and their parents.

The main implication with this study is that ADHD which is frequently comorbid with ODD or CD causes adolescents to perceive interpersonal conflicts within the family ( and possibly outside the family) as being more extreme than they truly are.

This means that adolescents with ADHD may overreact to interpersonal conflicts with extreme behaviors that the situation does not warrant. One of the main difficulties with this study was the fact that Wymbs, Pelham, Molina and Gnagy (2008) chose to study too many variables. By focusing on ADHD, ODD and CD they have created confounding variables that influenced the reliability of this study.

Many have questioned what can be done to help children and adolescents deal with the interpersonal relationship problems that can be created by ADHD. There have been several different solutions offered one of which is a psychosocial intervention program that is conducted on the computer. Shuenn-Tan and Sum-Cheung (2008) created an intervention in which they had a 7 year old boy participate in a collaborative school project on the computer with several other non- ADHD students.

Shuenn-Tan and Sum Cheung (2008) hypothesized that collaborative group work would foster a positive relationship between the child and his peers.

After the completion of the group project the researchers found that the students rated the student with ADHD as being more socially acceptable than they had prior to the study, and that the students in the classroom demonstrated a marked improvement in how they treated the student with ADHD.

This study indicated that when teachers use an ADHD student’s strong points to create a psychosocial intervention in order to foster positive interpersonal relationships between the student and the rest of the class it can have positive results. However; this study’s main weakness lay in the fact that Shuenn-Tan and Sum-Cheung (2008) only studied one student and therefore, the sample size limited the generalizability and reliability of this study.

The final major issue that one must address when discussing ADHD and interpersonal relationships is the question of what happens to people with ADHD as they become adults.

Do they continue experiencing deficits in their social relationships, and problems with interpersonal relationship? Or, do they develop means by which they cope with the social problems that plagued them throughout childhood and adolescents?

Friedman et al. (2003) hypothesize that adults with ADHD still experience significant social deficits and problems with interpersonal relationships.  In a study of 31 adults with ADHD and 32 non-ADHD adults Friedman et al. (2003) found that adults with ADHD still experienced social and emotional problems with their interpersonal relationships.

They found that participants with ADHD were less socially competent and more likely to be hypersensitive to social norms and values. Participants with ADHD were also more likely to take criticism from peers and family members more seriously and were more likely to experience extreme emotional reactions to normal social stimuli within an interpersonal relationship.

According to Friedman et al. (2008), participants were significantly more aware that they had social deficits that prevented them from developing healthy interpersonal relationships; however, the participants with ADHD were primarily unaware of emotional deficits that impacted their interpersonal relationships.

II. Implications and Recommendations

There are several major implications of research on interpersonal relationships and ADHD throughout the lifespan. First, these research studies imply that social deficits can affect all interpersonal relationships in the life of a person with ADHD.

These deficits can create problems in terms of peer relationships throughout childhood and adolescence and problems with interpersonal family and professional relationships as adults.

A second implication of this research is that problems with interpersonal relationships experienced by people with ADHD can be treated. By teaching those coping mechanisms to help them get along better with others, and by developing psychosocial intervention programs people with ADHD can have normal, fulfilling, interpersonal relationship.

A third implication of the research discussed in this paper is that helping people with ADHD develop the skills they need to make up for social and emotional deficits is crucial in helping them learn to deal with interpersonal relationships and conflict. Finally, this research implies that more attention must be focused upon the social deficits and emotional deficits experienced by adults with ADHD.

There are several recommendations that could be made as a result of the research that has been reviewed in this paper. First, it can be recommended that more effort needs to be placed into the development of psychosocial interventions in order to help people with ADHD deal with interpersonal relationships.

Second, it can be recommended that researchers focus more on the study of how ADHD affects the interpersonal relationships of adults with this disorder. Although, interpersonal problems as a child, or adolescent are serious as adults they can affect the ability of a person with ADHD to have either a successful career, or a family life.

Finally, it must be recommended that all due efforts be placed into discovering the causes of ADHD as well as in the development of more effective treatments for the people who experience this disorder.

Conclusion

It can be concluded that people with ADHD can have very serious problems with interpersonal relationships. People with this disorder are often rejected socially by their peers as a result of their impulsivity and the tendency to overreact to even the slightest criticism or social rejections with extreme behaviors.

Interpersonal conflict is a part of everyday life for people with ADHD; however, it should not have to be. Although the research indicates that these problems may be mostly resolved by adulthood, and that not all people with ADHD experience difficulties with interpersonal relationships, more attention must be focused upon how these social deficits in terms of interpersonal relationships affect the lives of adults with ADHD.

References

Friedman, S. L, Rapport, L. J, Lumley, M, Tzelepis, A, Van Voorhiis, A, Stettner, L &

Kakaati, L . (2003). Aspects of Social and Emotional Competence in Adult Attention Deficit Hyperactivity Disorder . Neuropsychology, v17, n1 , 50-58.

Hoza, B, Mrug, S, Gerdes, A. C, Bukowski, W. M, Kraemer, H. C, Wigal, T, Hinshaw, S. P,

Gold, J. A, Pelham Jr, W. E, & Arnold, E. I. (2005). What Aspects of Peer Relationships are Impaired in Children with Attention Deficit Hyperactivity Disorder? . Journal of Counseling and Clinical Psychology, v73, n3 , 411-423.

Nijmeier, J. S, Mindaraa, R. A, Buitelaar, J. K, Mulligan, A, Hartman, C. A & Hoekstraa, P. J .

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Wymbs, B. T, Pelham Jr, B. T, Molina, B. S. G, Gnagy, E. M . (2008). Mother and Adolescent

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